SCHIP Waivers Allowing States To Expand Coverage To Adults Break From Bush Administration's Position, Lawmakers Say

Main Category: Health Insurance / Medical Insurance
Also Included In: Pediatrics / Children's Health;  Smoking / Quit Smoking
Article Date: 25 Jun 2007 - 5:00 PDT

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AP/Long Island Newsday on Thursday examined how the Bush administration on May 30 granted a waiver to Wisconsin allowing the state to continue covering adults through SCHIP, even though the administration's official position is that the program should cover children exclusively. With lawmakers working to reauthorize SCHIP before it expires on Sept. 30, some lawmakers, including many Republicans, have said that the program should refocus on children in families with annual incomes less than 200% of the federal poverty level.

Senate Finance Committee ranking member Chuck Grassley (R-Iowa) said that the Bush administration "is having a hard time getting its act together." Grassley said, "On the one hand, the administration, like many members of Congress, doesn't believe this program should cover adults. On the other hand, the administration has approved and continues to approve adult coverage waivers." Committee Chair Max Baucus (D-Mont.) said, "There are a lot of ideological statements being made about how (SCHIP) should and should not work, but in practice, the administration is continuing to approve state waivers that run counter to their stated concerns."

According to the Government Accountability Office, Arkansas, Arizona, Colorado, Idaho, Illinois, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Virginia and Wisconsin have received federal waivers to expand SCHIP coverage to adults.

Dennis Smith, a CMS official, said that Wisconsin's waiver will allow the state to gradually move adults from SCHIP into Medicaid. "It would have been disruptive to the states and those families to change without adequate notice," Smith said.

Wisconsin Medicaid Director Jason Helgerson said that the state began enrolling adults in SCHIP because it already had a health insurance program for children when SCHIP was approved in 1997. In order to receive its full SCHIP allotment, the state enrolled adults in the program. Helgerson added that when adults receive health coverage, their children are more likely to be covered (Freking, AP/Long Island Newsday, 6/21).

Tobacco Tax
In related news, a "small but potentially powerful" group of Republican lawmakers has indicated that it will oppose any tax increase designed to fund SCHIP, including a proposed increase to the federal cigarette tax, The Hill reports. The Senate in March approved a test vote 59-40 on cigarette-tax language, but six out of nine Republicans on the Senate Finance Committee, not including the late Sen. Craig Thomas (Wyo.), voted against the language, "suggesting a hard road ahead," according to The Hill.

Senate Minority Leader Mitch McConnell (R-Ky.) said he would not support the tax increase but believes proponents will "enjoy considerable support." McConnell added, "Most people don't like taxes, but if (people) said, 'What's your favorite tax?' (the tobacco levy) would probably be it."

Senate Minority Whip Trent Lott (R-Miss.) said more Republicans might support the tax increase if the reauthorization bill includes a provision limiting SCHIP eligibility to children. Lott said, "Maybe you could accept (the tax hike) if you can hold the program cost down" (Schor, The Hill, 6/21).

Meanwhile, representatives from Families USA, America's Health Insurance Plans, the American Medical Association, the American Hospital Association and the American Cancer Society on Tuesday released a survey of 1,000 likely voters that showed 67% "strongly support" a 75-cent increase in the federal tobacco tax to fund health coverage for children. Families USA Executive Director Ron Pollack said, "We will support any increased tax on tobacco to help fund the SCHIP program, and we want to let Congress know that the American people will, too" (Kelly, CQ HealthBeat, 6/19).

ABC News Examines SCHIP
In the final report in a three-part series on uninsured children, ABC's "World News" on Sunday examined the debate over funding for SCHIP. "World News" profiled families enrolled in Georgia's SCHIP program, called PeachCare, which was under an enrollment freeze because of a funding shortfall (Harris, "World News," ABC, 6/17). The state Board of Community Health on Thursday voted unanimously to preliminarily approve lifting the enrollment freeze on July 12 to allow more than 20,000 children to enroll in the program.

SCHIP will expire on Sept. 30 if it is not renewed by Congress (Kaiser Daily Health Policy Report, 6/19). Legislation supported by some congressional Democrats would authorize an additional $50 billion to expand SCHIP, while the Bush administration supports a $5 billion expansion, "World News" reports. HHS Secretary Mike Leavitt said, "Having the SCHIP program become the engine that pulls the train of government-run health care isn't the way to go about it," adding, "When Washington takes over health care, you end up with fewer choices, long waiting lines and higher taxes."

Pollack said, "To say that is government takeover of the health care system is a disgrace." He added," What this debate is about is to provide a safety net for children and families." "World News" also spoke with Georgia Gov. Sonny Perdue (R) and families enrolled in the state's SCHIP ("World News," ABC, 6/17).

Video of the segment and expanded ABC News coverage are available online.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.